Transcript of 9th Session between Charles Balis, M.D. and Ms. Cassandra Evans, Thursday, October 3, 1996 at 5:30 pm.

Dr. Balis: Hello Cassie. I'm glad you could make it in person.
Ms. Evans: I almost didn't. But I really needed to talk. I had to take a cab over because I am not feeling all that well today. In fact, I missed work. I left a message in the office and a separate one for Ms. Bows. I really want to explain to her that I am not just loafing off. I mean, if I lose my job, I lose my job. I am not quite on a lucky streak right now. And I have other things on my mind. But I respect her as well as admire her and I don't want to disappoint her.
Dr. Balis: That is admirable of you. I am sure she will appreciate it. You mentioned in one of your sessions that you are a conscientious worker. I am sure missing a few days won't destroy your career at SII.
Ms. Evans: Yes I suppose. I don't know. Doctor, if I lose my job will you still be able to see me? As a therapist, I mean. I know I am in an HMO, and that you have a special relationship with the company.
Dr. Balis: Actually, I have an arrangement with the insurance company which provides health care to your company under an HMO. However I still have private patients and would be happy to continue seeing you. But I think we are getting ahead of ourselves. Tell me how your week was.
Ms. Evans: Jeez. It was quite crazy. Michelle called because she is coming in this weekend. She had all these massive plans for us and wanted to share them with me. She called on a very bad day for me. I couldn't think straight. It was horrible. She asked me if everything was okay. So I started to cry. I feel like such a failure.
Dr. Balis: Then what happened.
Ms. Evans: Well she asked me what was wrong, so I told her I wasn't feeling too well. She then said that she hoped I would be feeling better for her visit since she had all these exciting things planned. What could I tell her? I don't know if I am going to get any better. I don't know if I am going to get worse. Heck, I don't think the doctors know a damned thing more than I do at this point! I couldn't stop crying. I finally asked her if I could call her back. She was hesitant to let go. But she did and after a few minutes I was able to compose myself and return the call. I explained to her that I had finally been given a diagnosis. She replied, "Yea for you!" She knew how frustrating it was for me to be ill and not know what was wrong with me. Then I started to explain what it all meant. She always believed that when I had a diagnosis, a cure or treatment would shortly follow. She was so bummed for me. It was nice to share the news with someone who really cares. Someone who is truly supportive and wants to hear the whole story. She is even going to call the CDC and try to get some more information.
Dr. Balis: So she was receptive and supportive?
Ms. Evans: Yes and I am quite relieved. That pissy girl's reaction still haunts me. If a friend acted like she did...I think I would hide in a hole forever.
Dr. Balis: I think you will find more supportive people as well. Have you said anything to Brian?
Ms. Evans: Yes I did.
Dr. Balis: What was his response?
Ms. Evans: He asked what it all meant. Then he asked me if that is why I won't sleep with him. I was rather shocked. I mean he was so forthright about it all. He then began asking if this thing is contagious. He totally freaked and asked how I could put him in jeopardy if I knew something was wrong. I started to cry and then he got apologetic. That's when I hung up the phone.
Dr. Balis: Hmm.
Ms. Evans: He called back and left a message on my machine. There was no way I was going to talk to him. Every day he leaves another message. "Hi, it's me, Brian. I think we need to talk. I'm sorry about everything. Please call me." I have yet to call him. I need some space--some time to figure everything out.
Dr. Balis: And what have you figured out thus far?
Ms. Evans: I'm not sure. On the one hand I don't know if I love Brian. Or even if I could love him. Which means I should just end things already. But right now he is willing to have me and I am not sure I will get to be so lucky again.
Dr. Balis: Lucky? What do you mean?
Ms. Evans: Well, considering I have this illness--Chronic Fatigue Syndrome. Did you know that isn't even the real name? It is called Chronic Fatigue and Immune Dysfunction Syndrome. In Japan, they call it Killer Cell Syndrome, because it destroys the immune system. In Canada and the United Kingdom, it's called myalgic encephalomyelitis. Actually, I am not sure if I have that name exactly right--it is quite the mouthful!
Dr. Balis: Actually that sounds like a better name than chronic fatigue syndrome. Let's see--myalgic means muscular pain and encephalomyelitis is a viral infection of the central nervous system, which seems to capture it fairly well.
Ms. Evans: I've never liked the name chronic fatigue syndrome, it makes it sound like you're just sleepy or something. Did you know Florence Nightingale was rumored to have this illness in her later years?
Dr. Balis: No I didn't know that. I guess it shows you that you can still be a pretty amazing person even with this illness.
Ms. Evans: I guess so. I didn't think about it that way.
Dr. Balis: Maybe you can find a book about her and learn more about her life. See her as a role model.
Ms. Evans: That's a pretty good idea. I wonder what it must have been like for her. I met this woman through a support group network. She has had CFIDS for five years or so.
Dr. Balis: CFIDS?
Ms. Evans: Oh, that's what they call it--Chronic Fatigue and Immune Dysfunction Syndrome. CFIDS. Anyway, with the diagnosis procedure so crazy, she isn't quite certain about the onset. Anyway, she has two young girls and a husband. She is totally bedridden at this point. She had been working part time and taking care of the house. She just got sicker and sicker and then one day couldn't get out of bed. Her children leave some food and an icebox by her bed before they leave for school. Her husband calls around lunch time to check on her. Then when the girls come home they begin preparing dinner. She has to schedule her bathroom visits around who is going to be in the house with her. It is so sad.
Dr. Balis: It is, but she seems to have found a way to manage. As you will. And you are much better than she is
Ms. Evans: Thank God for that! To tell you the truth, I've been thinking about finding a roommate. Someone who would be able to help me out with things. In return, I will give the person a great deal. My apartment is very lovely and spacious.
Dr. Balis: That is productive thinking.
Ms. Evans: Thanks. What can I say, sometimes the noggin actually works! I wish Michelle lived out here--that would be perfect. Oh well. Doctor, do you have anything to drink here? I am getting a little light headed and a sip of something would do me a world of good.
Dr. Balis: Sure. I have a dispenser in the other room. You rest. I will go get it for you.
Ms. Evans: Thanks.
Dr. Balis: There you go.
Ms. Evans: Thanks again. Ah...much better. It's like I can feel the fluids drain right out of my body and my temperature skyrocket. Very weird.
Dr. Balis: Have you seen Dr. Halsey again?
Ms. Evans: No, not yet. We have been playing phone tag mostly. I turn the ringer off on my phone when I feel like crap, so I missed a couple of his calls. I heard he is going to try to attend a conference on CFIDS so he can better treat me. At first he wanted to refer me to this big wig specialist. The guy has been doing research for many years and has published a lot in the scholarly journals. But he doesn't accept any insurance and expects cash up front. To top that off, he charges $800 and up for a round of blood tests and a $375 consultation fee for the first 30 minutes. That is a lot of money, you know? Just to get a diagnosis from him. He doesn't accept patients unless he has personally diagnosed them. Then he charges $300 for a follow-up visit where he explains what his findings are. After that, visits are $275 for a fifteen minute visit or phone consultation. The nerve! Here he is dealing with a group of desperate patients, many whom cannot work and have already spent life savings on doctors and tests and phony cures, and he is ready to bleed them dry! Ugh. I can not respect that. If he had the cure then maybe. But just to be monitored, I don't think so.
Dr. Balis: I had no idea. That's a shame. I am glad that Dr. Halsey is willing to go to those extra steps for you.
Ms. Evans: Yeah, he's a nice guy. I get so nervous around most doctors--I don't trust them more than I could throw them. But you and he are actually human. I am very glad that I found you both to help me deal with my lot in life.
Dr. Balis: Good. Well let's leave it on that upbeat note, at least for me. Our time is up for today. Shall we schedule an appointment for next week, same time?
Ms. Evans: Yes. That would be great. Can I borrow the phone to call a cab to take me back home?
Dr. Balis: Sure. You can use the one in the other room. And feel free to wait there until the cab arrives.
Ms. Evans: Thanks Doctor. Have a good week.
Dr. Balis: You too Cassie. Bye.
Ms. Evans: Bye.
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Button to Dr. Balis' Notes Doctor Balis' Notes on this Session

Button to Cassandra Evan's Transcripts Transcripts of Cassandra Evans' Therapy Sessions
Button to Cassandra Evan's Patient File Cassandra Evans' Patient File

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